I’m dreaming of a white Halloween

Well, we’re digging out from a significant snowstorm here in Denver.  Fortunately, the hiking boots that I’ve been wearing provide enough support so that I can do some shoveling.  Last week, my PT told me that I could transition from the hiking boots to running shoes tomorrow.  I think I’ll stick with the boots until the snow gets cleared…

Before clearing……….after clearing……….snow dog

Who knew that my first published photos would be of something other than my ankle?

Don’t throw the crutches away just yet

So, I had my second physical therapy session yesterday and was given a wide, thin, rubbery band to use for providing a small amount of resistance for stretching.  The therapist made a bit of a loop and put the loop around my foot and, holding the free end, had me dorsiflex.  She then handed me the free end and had me plantarflex.  She showed me how to put the free end around my other foot for lateral work, and then had me cross my legs to pull medially.

This morning as I was going through my exercises, when I came to the rubber band part, I was a bit stumped since I had no one to hold the free end away from me (PT doesn’t do 0530 house calls and the rest of my family doesn’t do 0530 wake-up calls).  Then my crutches caught my eye.  I held the crutch backwards, looping the free end of the band around the upper end of the crutch.  Worked like that was what it was made for.  Hurray for small victories!

More on healing long

Happened to see my orthopod (Dr. Ted Parks) in the OR lounge today and relayed what my PT told me on Wednesday.  He said that he didn’t mind my treatment being a little more conservative now, but that he had absolutely no concerns that I would heal long.  Given that he is the one who put my tendon back together and saw how it looked (on the inside) after the repair, I am lowering my own concern level.  I’ll still keep my lifts in as directed by my PT, but I’m going to lengthen my walking stride a little more and try to walk as normally as possible.  Nothing like feeling like a bit of a ping-pong ball between differing opinions, eh?

Startin’ PT

Started physical therapy today.

My therapist said he was “shocked” that I walked in without “the boot”, but after telling him that my surgeon (Dr. Ted Parks - I’m gonna plug him shamelessly from now on…) said that it was OK for me to be in hiking boots, my therapist agreed.  I did get a mini-lecture on the perils of healing long and was given an extra 10 mm worth of heel wedge to put in my hiking boots.  Given what I’ve read here, I was in complete agreement with my therapist’s plan to wait another 2 weeks (until I am 8 weeks out) before doing any stretching or strengthening.  So, what did I get today?  First an exam, then heat, ultrasound, massage, 15 min on an exercise bike, using my toes to bunch up a towel on the floor, and then ice.  Nearly all of it peppered with more warnings about progressing too quickly and healing long.  The only thing that hurt some was when he was massaging away the edema on the top of my foot.   I’ve been being rather ginger with the area around my incision, and it felt surprisingly good to have a firmer hand there.

I’ve been given a couple of things to do on my own and OK’d to be on the exercise bike at home which is good, because I feel like I’m starting to put on some extra weight.  Speaking of weight, I’ve been surprised that I haven’t put on more.  My activity level is obviously way down and I’ve actually been eating more - especially during the first two weeks when I wasn’t working.  I am wondering if the injury/surgery induces somewhat of a hypermetabolic state?  Googling “injury hypermetabolism” yields a bunch of citations regarding severe burn and head injuries, so no help there…oh, well.

2-shoes

Well, today has been rather as I had expected.  I found that if I walked reallllllly slowly and took small steps I could walk evenly.  I did have a couple of times where I sort of wished that I had worn the boot - I was to a point yesterday that I could walk fairly briskly in the boot (a good thing since it was snowing here in Denver!).  But, I reminded myself to just be happy that I could walk in hiking boots instead of in “the boot”.  By early evening (of course, at my son’s soccer practice), it felt like my foot and ankle were quite swollen, so I climbed into the back seat of my car, sat sideways, and put my foot up onto the top of the other seat.  By the time the practice was finished, I felt much better.  As I take my hiking boot off now, I am pleased that there is less swelling than I would’ve predicted.  Thanks again to all who have commented.  Cheers, Ron

Woohoo!

This humble correspondent has graduated out of “the boot” into hi-top hiking boots.  So much more comfortable, although it did feel very strange putting on something other than “the boot”.

Earlier this afternoon, my surgeon (Dr. Ted Parks in Denver) explained to me the science behind early mobilization as opposed to prolonged casting.  My understanding of what he told me is that apparently, animal studies were done to mimic ligament/tendon injuries.  The control group of animals were immobilized following injury and the test group were fitted with braces that allowed movement, yet prevented strain on the injured area.  Under a microscope, the collagen fibers (the cells that provide the strength) in the test group were aligned in a linear orientation similar to uninjured tendons.  The fibers in the control group were randomly aligned.  The conclusion being that the early movement yielded healed tissue that more closely resembled uninjured tissue.

Now I am just waiting for a call from his office to let me know where I might go for physical therapy

A question for any and all…

On the eve of my 5-wk post-op visit (when I get to find out when I get to start PT), I thought I’d pose a question:

Aside from the immediate post-op concerns of bleeding, infection and non-healing, what would be the most concerning thing headed into physical therapy.  My list is as follows:

1. re-rupture

2. healing “long”

3. healing “short”

4. continued, chronic pain

What say you?  And are there any other potential pitfalls that I haven’t thought of?

Passed another milestone…

I passed a personal milestone yesterday by taking call.  Fortunately, I had a pretty reasonable day and only was called for one extra case and was home before 11PM.  It was a milestone for me because I was really hating having to be a burden on the rest of my group.  Now that I am crutch-free and able to take call, I consider myself to be back to work 100%.  As expected, given the longer day, my ankle and foot were more swollen than they had been the day before.  The swelling did resolve after a night of elevation, though.

Bye, bye crutches

Had a full list of cases (7) on Friday and got around without crutches most of the time.  I only used the crutches to get from/to the car because I could cover the longer distance faster with the crutches than without.  I did get a lot of comments to be careful that I didn’t mess up my hip or back due to the difference in height between the boot and my regular shoe.  I think that I’ve found a good solution to that: I replaced the folded sock and some of the padding in the boot with a Dr. Scholl’s massaging gel Arch Support.  Oh, what a difference.  My heel was feeling rather sore after Friday at work and I was also feeling like I was lacking arch support as well.  With these inserts, I’ve been walking around the house this weekend feeling much better.  I put the other support (they come as a pair) in a running shoe and I am now nearly level.  No more walking on tiptoe with my uninjured foot.  I will report as well that I spent much of the weekend in the recliner watching football.  Got a good cardio workout just by watching the Notre Dame v. Purdue game.  I think that my heart rate was in the 140s for the entire 4th quarter.  Now that I’ve reached a point where I don’t need the crutches, I am not going to try to push things too far.  Yeah, the competitive part of me would love to set the world record for recovery, but since I don’t make a living by running, I don’t want to risk a re-rupture.

I’m walking!

So, I had the day off today.

After helping get the kids off to school, I went back to bed (sleeping in is a wonderful thing), with my foot elevated.  After I got up, I went to the recliner to read the paper.  Once finished with the paper, I started cleaning up my office.  Needing to use both hands, I set the crutches aside and found myself able to move around without them - just a few back and forth steps.  This emboldened me to try to take a trip to the kitchen sans crutches, which I did - pain free.  I guess my question now is whether this constitutes full weight bearing or whether FWB means being able to stand on the injured leg while lifting the other leg off the floor?  Either way, I am very pleased.  After finishing my cleaning/organizing, I took the boot off to do some stretching.  I was also very pleased the the swelling was down such that I could see both the tendons and veins on the top of my foot.

Since it is looking like I’ll have a full day at work tomorrow, I do plan to bring the crutches to work and probably crutch around most of the day to avoid overdoing it.